What it is

Glenohumeral instability ranges from repeated subluxations to complete dislocations. The ball slips from the socket due to trauma or laxity. First-time dislocations often follow a fall or a tackle. Ongoing instability may need surgical stabilisation.

The plan rebuilds control, strength, and confidence. Decisions are made considering age, sport, and recurrence risk.

What happens when it occurs

The capsule and labrum are stretched or torn. The cuff and scapula must work harder to centre the ball. Rehabilitation rebuilds control. Surgery reconnects or tightens the labrum and capsule when needed.

Common causes and risk factors

  • Tackles and falls with the arm out to the side
  • Overhead and contact sports
  • Generalised ligament laxity
  • Previous dislocation

Who is most affected

Teens and young adults in contact and overhead sports. Men present more often.

Typical symptoms

  • Feeling of giving way or sliding
  • Pain with elevation or external rotation
  • Weakness and apprehension in vulnerable positions

When to seek care

Immediate care for a suspected dislocation. Early review after reduction to a rehabilitation plan.

How we diagnose

History of events, apprehension tests, and imaging. MRI arthrogram assesses the labrum and capsule when needed.

Management

  • Short period of protection after reduction
  • Strength and control for the cuff and scapula with gradual exposure to vulnerable positions
  • Return to contact and overhead tasks after testing
  • Surgical stabilisation for recurrent or high-risk cases

Rehabilitation milestones

Phase 1 weeks 0 to 3: pain control, protected range, isometrics.

Phase 2 weeks 3 to 8: progressive range, strength, and control.

Phase 3 weeks 8 to 16: exposure to external rotation and abduction, sport drills.

Phase 4 months 4 to 6: contact and overhead testing before full return.

Readiness to progress

  • No apprehension in the position of risk
  • Strength within 90 per cent
  • Hop style plyometric upper limb tests passed

Prevention

  • Keep shoulder strength and control high
  • Use graded contact exposure in preseason
  • Protect the arm during falls when possible

Australia snapshot

  • Common in rugby league, rugby union, AFL, and court sports
  • Men present more often than women in sports clinics
  • Public and private pathways offer reduction, imaging, and stabilisation

Latest insights

Control in vulnerable positions is the key skill. Build it before returning to contact.

High-risk athletes often choose early stabilisation after a first dislocation.

Frequently Asked Questions

Risk is higher in younger athletes and those participating in contact sports. Strong control and, for some, surgery reduce recurrence.

Helpful in the early stages of return for contact drills. Not a substitute for control.

Commonly, several months with criteria-based testing before return.

Yes, with careful choices early and a focus on control.

Used to assess the labrum and capsule and to guide decisions.

Numbness, persistent weakness, or repeated giving way need review.